Active NPI
West Gardena Care Center LLC
Doing business as West Gardena Post Acute
- Skilled Nursing Facility
- Gardena, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- WEST GARDENA CARE CENTER LLC
- Doing business as
- West Gardena Post Acute
- Practice address
- 16530 S Broadway
Gardena, CA 90248-2714 - Phone
- (917) 842-8361
- NPI assigned
- Oct 24, 2019
- Last updated
- Oct 6, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Chonoch Gewirtz
- Title
- Owner
- Phone
- (310) 329-9929
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NU | Primary |
Addresses
Primary practice location
16530 S Broadway
Gardena, CA 90248-2714
Mailing address
6442 Coldwater Canyon Ave Ste 100
North Hollywood, CA 91606-1191
Phone (310) 329-9929
Other names 1
- West Gardena Post Acute
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191120001679 | CA | Part A Provider - Skilled Nursing Facility | 7214369800 | Practice locations: Gardena, CA |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1407499163. Details of each certification follow.
Skilled nursing facility certification: CCN 555410
- Legal name
- WEST GARDENA CARE CENTER LLC
- Doing business as
- WEST GARDENA POST ACUTE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 1, 1989
- Last certification
- Oct 3, 2024
- Beds
- 50
- Ownership / control type
- Limited Liability Corporation
- Organization structure
- LLC
- Incorporated
- Oct 7, 2019 in CA
- Enrollment address
- 16530 S Broadway
Gardena, CA 90248-2714 - Nursing home name
- WEST GARDENA POST ACUTE
- Affiliated entity
- ABRAHAM BAK & MENACHEM GASTWIRTH
Care Compare: Nursing home
Medicare Care Compare- Listed as
- West Gardena Post Acute
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Oct 1, 1989
- Medicare certification status
- Active
- Certified beds
- 50
- Chain
- Abraham Bak & Menachem Gastwirth
- Penalties (3 years)
- 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D0891504 | West Gardena Post Acute | Certificate of waiver | Sep 8, 2026 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 14
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Chonoch Gewirtz | 5% Or Greater Direct Ownership Interest | Nov 1, 2019 | 5% |
| Adp of the SNF | Oct 7, 2019 | ||
| Juda Bak | Adp of the SNF | Sep 6, 2019 | |
| Mgaz Consulting LLC | Adp of the SNF | Dec 27, 2021 | |
| Abe and Rachel Bak Family Trust | Adp of the SNF | Nov 10, 2021 | |
| 16530 South Broadway Street,LLC | Adp of the SNF | Sep 6, 2019 | |
| Rachel Deena Bak | Trustee of the SNF | Jan 13, 2016 | |
| Adp of the SNF | Sep 6, 2019 | ||
| Kingsley Ofoegbu | Operational/Managerial Control | Jun 13, 2022 | |
| Adp of the SNF | Jun 13, 2022 | ||
| Bagz Holdings, LLC | Adp of the SNF | Nov 10, 2021 | |
| Violeta Pangilinan | Operational/Managerial Control | Oct 16, 2023 | |
| Adp of the SNF | Oct 16, 2023 | ||
| Kenneth Lehmann | 5% Or Greater Direct Ownership Interest | Nov 1, 2019 | 32% |
| Managing Control - Governing Body | Oct 7, 2019 | ||
| Adp of the SNF | Sep 6, 2019 | ||
| Abraham Bak | 5% Or Greater Direct Ownership Interest | Nov 1, 2019 | 31.5% |
| Operational/Managerial Control | Oct 7, 2019 | ||
| Managing Control - Governing Body | Sep 6, 2019 | ||
| Trustee of the SNF | Jan 13, 2016 | ||
| Adp of the SNF | Sep 6, 2019 | ||
| Henry Gastwirth | Adp of the SNF | Sep 6, 2019 | |
| Abak Consulting LLC | Adp of the SNF | Dec 27, 2021 | |
| Menachem Gastwirth | 5% Or Greater Direct Ownership Interest | Nov 1, 2019 | 31.5% |
| Operational/Managerial Control | Oct 7, 2019 | ||
| Managing Control - Governing Body | Aug 19, 2020 | ||
| Adp of the SNF | Sep 6, 2019 |
Owners & managing parties with NPI records 2
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
- Dermatology Physician
- Burbank, CA
- NPI 1447495031
Adp of the SNF, Trustee of the SNF
-
- Family Medicine Physician
- Inglewood, CA
- NPI 1285732354
Adp of the SNF, Operational/Managerial Control
Practitioners & affiliated clinicians
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1601942400000",
"number": "1407499163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6442 COLDWATER CANYON AVE STE 100",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916061191",
"telephone_number": "310-329-9929"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16530 S BROADWAY",
"city": "GARDENA",
"state": "CA",
"postal_code": "902482714",
"telephone_number": "917-842-8361"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST GARDENA CARE CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-10-24",
"last_updated": "2020-10-06",
"certification_date": "2020-10-06",
"status": "A",
"authorized_official_last_name": "GEWIRTZ",
"authorized_official_first_name": "CHONOCH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "310-329-9929"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "West Gardena Post Acute",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "West Gardena Post Acute",
"code": "3",
"type": "Doing Business As"
}
]
}
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- Well2Thrive Psychological Consulting
- Wellness Company a Ca Family Therapist Professional Corporation (The Wellness Company Ca)
- Rebecca Eileen Welty
- Alexandra Werner
- Connie L Werner
- West Gardena Community Clinic
- Deon Ziliphia West, CASE MANGER
- Western Dental Services, Inc.
- Western Medical Supply Services Inc.
- Antonia Whatley
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.